LONG-TERM NUTRITIONAL CONSEQUENCES OF BOWEL SEGMENT USE FOR LOWER URINARY-TRACT RECONSTRUCTION IN PEDIATRIC-PATIENTS

Objectives. To identify whether nutritional abnormalities, specificall y vitamin B-12 deficiency, folate deficiency, and low carotene levels, are long-term sequelae of the use of ileum and/or colon for lower uri nary tract reconstruction in pediatric patients. Methods. Serum levels of vitamin B-12, methyl malonic acid (MMA), carotene, and folate were measured 3 to 13 years (mean 6) after surgery in patients less than 1 8 years old at the time of operation. Results. Thirteen (44.8%) of 29 patients had abnormal nutritional serum levels, with 5 (38.5%) of 13 h aving more than one abnormal value. Vitamin B-12 was low in 4 (14%) of 29 patients; MMA was abnormally high in 7 (26%) of 27; and both folat e and carotene levels were low in 4 (14.8%) of 27. No patient with rec onstruction with colon alone (n = 3) had abnormal values, and no patie nt had any clinical signs or symptoms of vitamin B-12 deficiency or fa t malabsorption.Conclusions. Nutritional abnormalities can occur in pa tients after lower urinary tract reconstruction with ileum. No patient in this study had symptomatic abnormalities; however, long-term clini cal effects may be significant. The implications of low folate levels in women of childbearing age must also be taken into consideration bec ause of the potential association with congenital anomalies. (C) 1997, Elsevier Science Inc. All rights reserved.